Patient profiles and outcomes of chronic total occlusion percutaneous revascularisation in middle- and high-income regions a cross-sectional study from the European Registry of Chronic Total Occlusions (ERCTO)
Background - National income level influences the prevalence and outcomes of cardiovascular disease (CVD), with lower-income countries contributing disproportionately to the global CVD burden. Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) requires specialised equipment, incr...
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| Autori principali: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
1 October 2026
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| In: |
International journal of cardiology
Year: 2026, Volume: 460, Pages: 1-10 |
| ISSN: | 1874-1754 |
| DOI: | 10.1016/j.ijcard.2026.134625 |
| Accesso online: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ijcard.2026.134625 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0167527326004754 
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| Note sull'autore: | Giuseppe Vadalà, Kambis Mashayekhi, Cristina Madaudo, Michael Behnes, Mohamed Ayoub, Sevket Gorgulu, Gerald S. Werner, Nihat Kalay, Alexander Avran, Omer Goktekin, Roberto Garbo, Wojcik Jaroslaw, Myron Zaczkiewicz, Juergen Arnez, Stylianos Pyxaras, Evald Høj Christiansen, Juan Luis Gutiérrez-Chico, Nicolaus Boudou, Sinisa Stojkovic, Gabriele L. Gasparini, Pierfrancesco Agostoni, Roberto Diletti, Carlo di Mario, Laura Maniscalco, Josko Bulum, Edina Cenko, Alfredo R. Galassi, EURO CTO investigators |
| Riassunto: | Background - National income level influences the prevalence and outcomes of cardiovascular disease (CVD), with lower-income countries contributing disproportionately to the global CVD burden. Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) requires specialised equipment, increasing procedural costs. However, whether national income level contributes to disparities in managing patients with CTO remains unclear. - Objective - To compare the clinical profiles, procedural settings and outcomes of patients undergoing CTO-PCI in middle-income countries (MICs) and high-income countries (HICs). - Methods - This cross-sectional study included 15,329 patients who underwent CTO-PCI between 2021 and 2023. Data were obtained from the European Registry of Chronic Total Occlusions (ERCTO). Of the 24 enrolling countries, 7 were classified as MICs and 14 as HICs. - Results - Patients in HICs were older (67 ± 10 vs 61 ± 10 years; p < 0.001) and presented with greater CTO complexity (J-CTO score: 2.31 ± 1.25 vs 1.99 ± 1.17; p < 0.001). Conversely, patients in MICs were more likely to have diabetes (35% vs 29%; p < 0.001) and to be active smokers (59% vs 49%; p < 0.001). Patients in MICs had lower use of mechanical cardiac support (0.1% vs 0.8%; p < 0.001), advanced calcific plaque modification devices (1% vs 6.1%; p < 0.001), and intravascular ultrasound (14% vs 25%; p < 0.001). MICs achieved higher procedural success (89.5% vs 90.5%; p = 0.07) but higher mortality compared to HICs (0.6% vs 0.2%; p < 0.001). - Conclusion - Among a selected population of patients undergoing CTO-PCI, notable clinical, anatomical, and procedural differences exist between MICs and HICs. These findings highlight the importance of tailoring public health strategies to optimise cardiovascular care across diverse economic settings. |
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| Descrizione del documento: | Online veröffentlicht: 17. Juni 2026, Artikelversion: 26. Juni 2026 Gesehen am 29.07.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 1874-1754 |
| DOI: | 10.1016/j.ijcard.2026.134625 |